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Lead, Blood (Venous)
Ordering Recommendation
Recommended for routine testing for lead exposure. For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016).
New York DOH Approval Status
Specimen Required
Royal blue (K2EDTA), Royal blue (NaHep), or tan (K2EDTA).
Transport 3 or 6 mL whole blood in the original collection tube (royal blue). (Min: 0.5 mL) OR Transport 3 mL whole blood in the original collection tube (tan). (Min: 0.5 mL)
Room temperature. Also acceptable: Refrigerated.
Serum. Specimens collected in tubes other than Royal blue(K2EDTA), Royal blue (NaHep), or tan (K2EDTA). Clotted specimens. Capillary pediatric EDTA collection tubes, refer to Lead, Blood (Capillary) 0020745.
Trace Elements requisition form may be required (ARUP form #32990).
Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
Methodology
Quantitative Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Performed
Sun-Sat
Reported
1-3 days
Reference Interval
Effective December 6, 2021
| Age | Reference Internal |
|---|---|
| 0-5 years | Less than or equal to 3.4 µg/dL |
| 6 year or above | Less than or equal to 4.9 µg/dL |
Interpretive Data
Analysis performed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS).
Elevated results may be due to skin or collection-related contamination, including the use of a noncertified lead-free tube. If contamination concerns exist due to elevated levels of blood lead, confirmation with a second specimen collected in a certified lead-free tube is recommended.
Information sources for blood lead reference intervals and interpretive comments include the CDC's "Childhood Lead Poisoning Prevention: Recommended Actions Based on Blood Lead Level" and the "Adult Blood Lead Epidemiology and Surveillance: Reference Blood Lead Levels (BLLs) for Adults in the U.S." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.
| Children | |
|---|---|
| Concentration | Comment |
| 3.5-19.9 µg/dL | Children under the age of 6 years are the most vulnerable to the harmful effects of lead exposure. Environmental investigation and exposure history to identify potential sources of lead. Biological and nutritional monitoring are recommended. Follow-up blood lead monitoring is recommended. |
| 20-44.9 µg/dL | Lead hazard reduction and prompt medical evaluation are recommended. Contact a Pediatric Environmental Health Specialty Unit or poison control center for guidance. |
| Greater than 44.9 µg/dL | Critical. Immediate medical evaluation, including detailed neurological exam is recommended. Consider chelation therapy when symptoms of lead toxicity are present. Contact a Pediatric Environmental Health Specialty Unit or poison control center for assistance. |
| Adults | |
|---|---|
| Concentration | Comment |
| 5-19.9 µg/dL | Medical removal is recommended for pregnant women or those who are trying or may become pregnant. Adverse health effects are possible. Reduced lead exposure and increased blood lead monitoring are recommended. |
| 20-69.9 µg/dL | Adverse health effects are indicated. Medical removal from lead exposure is required by OSHA if blood lead level exceeds 50 µg/dL. Prompt medical evaluation is recommended. |
| Greater than 69.9 µg/dL | Critical. Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present. |
Laboratory Developed Test (LDT)
Note
Hotline History
CPT Codes
83655
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0020098 | Lead, Blood (Venous) | 77307-7 |
Aliases
- BLL
- Lead (Adult)
- Pb
- Pb, Blood
- Pb, Whole Blood
- Venous blood level
